HomeMy WebLinkAboutFILLED LAND AFFIDAVITPLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
SGNBY ED
FILLED LAND AFFIDAVIT St.Lucie County
I, the undersigned, am the owner of the following described property,
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(Parcel Id#/Legal description/Address) 04oi47Z C4A4-o GoL iIA4 AV G' LL14 Uk IF L La!/I
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
Property Owner Please Print)
roperty Owner Signature Date
STATE OF FLORIDA, COUNTY OF ��- &e" LS
ACKNOWLEDGED BEFORE ME THIS \ $ DAY OF 20 09
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BY 1 k 91U 5 6 101 fse6 WHO IS PERSONALLY KNO TO ME ❑(a OR WHO HAS
PRODUCED
NATURE OF NOTAR BLIC
///VVV/// COMMISSION NUMBER
SLCPDSD Rmi d 04/112011
AS IDENTIFICATION.
TYPE OR PRINT NOTARY
(SEAL)
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